Effects of Transmission Delay on Client Participation in Video-Mediated Group Health Counseling

Abstract

In face-to-face group counseling, active client participation contributes to the counseling agenda by a variety of social processes, but little is known about how video mediation shapes client participation. In this article, we use conversation analysis to investigate how transmission delay affects client participation in video-mediated group counseling through shaping the resolution of overlapping talk. Data are video recordings from three video-mediated group health counseling sessions recorded simultaneously in the two participating locations. The delay changes the timing of the overlapping turns and pauses at each end of the mediated counseling, making it difficult to interpret who should take the turn after the overlap. This may pose obstacles to client participation. While mediated counseling services can increase access to services and thus improve client participation at a macro level, transmission delay can pose threats to active client participation at the micro level of interaction.

Communication in Telehealth: A State-of-the-Art Literature Review of Conversation-Analytic Research

“…The second subtopic entails studies that investigate how technology plays a role in the emergence and resolution of silences in healthcare encounters, particularly where they are treated by the participants as problematic (e.g., silences where talk should occur; Olbertz-Siitonen, 2015 ; Ruhleder & Jordan, 2001 ). In telephone (Chatwin et al, 2014 ) and video calls (Ilomaki et al, 2021 ; Nielsen, 2020 ; Seuren & Shaw, 2022 ; Seuren et al, 2021 ; Shaw et al, 2020 ), silences between turns are more likely to occur. In chat encounters, extended silences are normal while turns are being typed (Stommel & te Molder, 2015a , 2015b ).…”

“…Patients seemingly have the primary right to continue, with clinicians producing repair strategies that concede the floor, but there is limited evidence on exactly who gets the right to talk when (Nielsen, 2020 ; Seuren & Shaw, 2022 ; Seuren et al, 2021 ; Shaw et al, 2020 ). While participants generally resolve these problems within a few turns (Seuren et al, 2021 ), Ilomaki et al ( 2021 ) show that in video-mediated group health counseling, participants may have different perspectives about the type of overlap that occurs and thus who has rights to talk, which may lead to diminished client participation.…”

Digital technology in physiotherapy consultations: Problem-solving sequences and recruitments

“…For various contexts, challenges of digital tools for patient participation have been identified by EMCA studies, for instance because a tool predefined a narrow instead of an open format of conversation (Schoeb & Hiller, 2018), professionals were more focused on the tool than the patient (Beck Nielsen, 2016), delays in remote video calls inhibited smooth turn-taking (Ilomäki et al, 2021), and medical information collected with digital self-reporting tools were treated as self-speaking and not discussed in consultations (Mikesell et al, 2018). Meanwhile, patients were also found to use strate-gies to regain professionals' attention despite the presence of a tool (Booth et al, 2013).…”

Using Linguistic Ethnography to Study Video Consultations: A Call to Action and Future Research Agenda

“…We know from our ethnographic data and other studies (e.g., Ilomaki et al, 2021) that participants are concerned with the conversational flow in video consultations. Most participants, both patients and clinicians, used mobile devices (smartphones, tablets, or laptops-sometimes in combination).…”

“…The literature on video consultations is growing rapidly ( Connolly et al, 2020 ; Ignatowicz et al, 2019 ; O'Cathail, Sivanandan, Diver, Patel, & Christian, 2020 ), but we have a limited understanding of what actually goes on in a video consultation, what makes it different from an in-person appointment, and what skills clinicians and patients need. Although Pappas and Seale (2009 ; 2010) began to investigate the interaction in video consultations over 10 years ago, it is only recently that more researchers have begun to look at these issues (e.g., Due & Lange, 2020 ; Ilomaki et al, 2021 ; Stommel & Goor, 2019 ; Stommel & Stommel, 2021 ). To support the use of video consultations in health services we need to know when video technology might appropriately be used.…”